The Importance Of Timing In Congenital Nasolacrimal Duct Obstruction (original) (raw)
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Success rate of probing for congenital nasolacrimal duct obstruction at various ages
Journal of ophthalmic & vision research, 2014
To determine the success rate of probing for congenital nasolacrimal duct obstruction (CNLDO) in various age groups. One hundred children (118 eyes) aged 4 to 48 months diagnosed with CNLDO were included and divided into 6 groups; group 1: infants 4-6 months of age, group 2: infants from 7 to 12 months, group 3: toddlers 13-18 months of age, group 4: older toddlers 19-24 months old, group 5: children from 25 to 36 months, and group 6: children 37-48 months of age. Probing was performed under general anesthesia in all subjects. All patients were followed at regular intervals up to 6 months postoperatively. Successful probing was documented as complete remission of symptoms 2 weeks following the procedure. The success rate of probing was 100% (2 eyes) in group 1, 94% (47 eyes) in group 2, 84.4% (27 eyes) in group 3, 83.3% (15 eyes) in group 4, 61.5% (8 eyes) in group 5 and 33.3% (1 eye) in group 6; the overall success rate was 84.7% (100 eyes). The majority of eyes, 87.3% (103 eyes), ...
British Journal of Ophthalmology, 2003
Aims: To find the cure rate of late (second year of age) and very late (3-5 years of age) initial probing for congenital nasolacrimal duct obstruction (CNLDO) and to identify the factors contributing to the failure rate of the probing in older children. Methods: In a prospective interventional case series study, 169 eyes of 125 consecutive patients (1-5 years old) with CNLDO underwent probing under general anaesthesia. Cure was defined as absence of tearing and discharge in the affected eye. Results: 138 eyes of 101 patients aged 13-60 months (mean 23.4 (SD 10.2)) were included. Of 15 eyes (10.8%) with complex CNLDO, 80% presented after 24 months of age (p<0.0001). The cure rate was 89% in patients 13-24 months of age and 72% after the age of 24 months (p = 0.01). It was 90.2% in the membranous and 33.3% in the complex CNLDO in both late and very late probing (p<0.0001). There was a high correlation (r = 0.97) and no significant difference between the cure rate at 1 week and final follow up. Conclusion: Accumulation of the complex CNLDO is the main risk factor for failure of probing in the older children.
Success rates of probing for congenital nasolacrimal duct obstruction at various ages
BMC Ophthalmology
Background Although nasolacrimal duct probing is the standard treatment for congenital nasolacrimal duct obstruction (CNLDO) among children, the optimal timing of this procedure has been a topic of debate. The aim of the study was to analyze the clinical efficacy of nasolacrimal duct probing among patients with CNLDO symptoms at various ages. Methods An 8-year retrospective study involved 2434 patients (3009 eyes), who underwent nasolacrimal duct probing conducted under topical anesthesia in the operating theatre. The study group consisted of 1148 girls (47.2%) and 1286 boys (52.8%) from 2 weeks to 41 months (average age was 8 ± 5.6 months). The participants were divided into nine age groups: 0–2 months, 3–6 months, 7–9 months, 10–12 months, 13–15 months, 16–18 months, 19–21 months, 22–24 months and over 24 months. Results Bilateral obstruction was present among 575 (23.6%) children and was associated with a higher percentage of unsuccessful procedures compared to patients with unil...
Asian Journal of Medical Sciences, 2018
Background: Congenital nasolacrimal duct obstruction (CNLDO) is one of the commonest problems encountered in daily ophthalmology practice. Though probing and syringing is the mainstay of management of CNLDO, there is no clear guideline about the optimal time to perform.Aims and Objective: To evaluate the efficacy of probing and syringing in cases of congenital nasolacrimal duct obstruction in various age groups.Materials and Methods: In this prospective, hospital based, interventional, cross-sectional study done over a period of 2 years (July 2015- June 2017), children of various age ranging from 10 days to 8 years who underwent probing and syringing under general anesthesia for CNLDO refractory to conservative measures were included. Results: Children of as young as 10 days to as older as 8 years underwent probing and syringing with male to female ratio of 1.2:1. Overall success was 80.6% (58/72) which was statistically significant when analyzed with age (P = 0.006). Majority of ca...
Success of probing for congenital nasolacrimal duct obstruction in children under 10 years of age
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2009
To determine the success of probing for congenital nasolacrimal duct obstruction in children aged under 10 years. A retrospective study. The medical records of all children aged under 10 years diagnosed with congenital nasolacrimal duct obstruction between 1997 and 2007 who underwent probing and irrigation under general anesthesia were reviewed. Successful probing was defined as absence of tearing and eye discharge in the affected eye at one month or more after treatment. Data obtained included age at first visit, gender laterality of the eyes, history of previous probing, age at probing time, number of probing, and treatment outcomes. Patients were categorized into four groups according to age at treatment (0-1 year, 1-2 years, 2-3 years and 3-10 years). Forty-four patients were seen during the study period, 19 males and 25females, with 29 right eyes and 30 left eyes undergoing treatments of 29 unilateral probing and 15 bilateral probing. The age at probing ranged from 10 months to...
Study of outcome of late probing in congenital nasolacrimal duct obstruction
IP innovative publication pvt. ltd, 2019
Abstract Purpose: To evaluate the outcome of nasolacrimal duct probing in children older than two years in congenital nasolacrimal duct obstruction. Materials and Methods: A Hospital based prospective interventional study of 20 cases of congenital nasolacrimal duct obstruction above 2 years of age was done. A thorough preoperative evaluation was done and diagnosis confirmed by negative Fluorescein dye disappearance. Patients underwent probing under general anaesthesia. Cases were followed up at 1, 4 and 12 weeks postoperatively. Successful outcome was assessed in terms of absence of watering or discharge and also positive Fluorescein dye disappearance test done at each follow up visit. Data was collected and analysed using descriptive statistics. Results: 23 eyes of 20 patients of simple congenital nasolacrimal duct obstruction in the age group of 2-6 years were included in our study. Lacrimal sac massaging was done previously in 17(85%) cases. 3(15%) patients underwent bilateral probing and 17(85%) unilateral probing. 16(80%) out of 20 patients had successful outcome in terms of resolved symptoms and signs. Conclusion: Late probing can be done as a primary intervention in children above 2 years of age with successful outcome instead of going directly for major procedures like dacrocystorhinostomy. Keywords: Congenital nasolacrimal duct obstruction, Probing, Flourescein dye disappearance test, Sac massage, Epiphora.
Annals of International medical and Dental Research
Background: Congenital Nasolacrimal duct obstruction (CNLDO) is one of the most common problems in the pediatric age group. It is the commonest cause of childhood epiphora. In most cases it is caused by incomplete canalisation of the nasolacrimal duct (NLD). Aim: The present study was conducted to determine the success rate of primary nasolacrimal duct probing in children older than two years of age. Methods: The present prospective study was conducted in the post graduate department of ophthalmology, Sher-i-Kashmir Institute of Medical Sciences and hospital Bemina. Fifty two eyes of forty two children underwent probing and syringing for nasolacrimal duct obstruction under general anaesthesia. Follow up was done at first week, fourth week and three months. Success was defined as complete absence of sign and symptoms. Statistical analysis was performed using SPSS version 17.0. P value of less then 0.05 was considered significant. Results: Success rate of S&P in our study was found to be 94.23 %. Simple obstruction was encountered in 44 (84.61 %) eyes and all resolved successfully post S&P. Complex obstruction was encountered in 8 (15.39%) eyes and only five resolved successfully post S&P giving a success rate of 62.5 % only. Conclusion: late probing should be performed as an initial surgical step in the management of every case of CNLDO presenting late in the course of the disease (> 2 years), before more invasive procedures are attempted.
Success Rate of Late Primary Probing in Congenital Nasolacrimal Duct Obstruction
Journal of Pediatric Ophthalmology & Strabismus, 2014
Purpose: To investigate the clinical outcomes of late primary probing in congenital nasolacrimal duct (NLD) obstruction. Methods: A prospective interventional study was designed to recruit children older than 24 months who presented with clinical manifestations of NLD obstruction since February 2008 to Farabi Eye Hospital, Tehran, Iran. No prior surgical intervention for NLD obstruction was performed on these patients; they underwent probing of the nasolacrimal system and irrigation under general anesthesia by oculoplastic surgeons. The outcome of the procedure was assessed 2 to 3 months postoperatively. Data of the patients until February 2013 were considered for analysis. Results: The total number of patients during the 5-year study was 343. The total success rate considering all of the age groups was 75.8%. The success rate was 85% in those who were 2 to 3 years old, 63% in those who were 3 to 4 years old, and 50% in those who were 4 to 5 years old. In patients with chronic dacryocystitis with mucopurulent discharge, 83% had successful probing and irrigation. In patients with epiphora with no mucopurulent discharge, 59% had successful results with probing. Conclusions: In the cases of congenital NLD obstruction, primary probing before 2 years of age has a high success rate; there is a high overall success rate (75.8%) in the 2-to 5-years age group, but when older than 5 years, further procedures such as intubation and dacryocystorhinostomy would be needed because of the high failure rate of probing.
Resolution of Congenital Nasolacrimal Duct Obstruction With Nonsurgical Management
Archives of Ophthalmology, 2012
Objective-To determine how often nasolacrimal duct obstruction (NLDO) resolves with 6 months of nonsurgical management in infants aged 6 to <10 months old. Methods-As part of a randomized trial evaluating the cost effectiveness of immediate office probing versus observation with deferred probing for unresolved cases, 107 infants aged 6 to <10 months old who had NLDO and no history of prior nasolacrimal duct surgery were prescribed 6 months of nasolacrimal duct massage and topical antibiotics as needed. Resolution of the nasolacrimal duct obstruction was assessed 6 months after study entry and was defined as the absence of all clinical signs of NLDO (epiphora, increased tear lake, or mucous discharge) and not having undergone NLDO surgery. Exploratory analyses assessed whether baseline characteristics including age, gender, laterality, and prior treatment were associated with the probability of NLDO resolving without surgery. Results-At the 6-month examination, which was completed for 117 of the 133 eyes (88%), the NLDO had resolved without surgery in 77 eyes (66%, 95% CI = 56% to 74%). None of the baseline characteristics we evaluated were found to be associated with resolution. Discussion-In infants 6 to < 10 months of age, more than half of eyes with NLDO resolve within 6 months with nonsurgical management. Knowledge of the rate of NLDO resolution in infancy without surgery will help clinicians and parents effectively discuss treatment options.
Journal of Evolution of Medical and Dental Sciences, 2018
BACKGROUND Congenital nasolacrimal duct obstruction is a condition where there is non-canalisation of nasolacrimal duct at its lower end at the level of valve of Hasner. It is the most common cause of epiphora in new-borns occurring in 20%-30% of the new-borns. About 1%-6% of these children become symptomatic and the most common symptom is epiphora. Aims and Objectives- To study the demographic profile of the patients presenting with congenital nasolacrimal duct obstruction. To study the outcome of treatment modalities in patients with congenital nasolacrimal duct obstruction. MATERIALS AND METHODS This is a prospective observational study. A minimum of 110 eyes of children aged < 4 years with clinical diagnosis of congenital nasolacrimal duct obstruction with classical symptoms of epiphora and regurgitation of watering and discharge or both on pressure at lacrimal sac area were included in the study. Each patient was subjected to detailed history taking regarding the symptoms and duration of the symptoms. A careful and detailed examination of the eye was undertaken. All the patients those who were of age less than six months were first subjected to conservative treatment of lacrimal massaging at home after demonstration at hospital, thereafter, those who failed to respond to treatment upto the age of six months were subjected to syringing and probing under general anaesthesia. All cases were reviewed at 4 th , 8 th and 12 th week. The patient was said to be cured if there was no recurrence of symptoms or discharge even after stoppage of antibiotics and massage for two weeks. RESULTS Out of 110 patients, 62 (56.3%) were males and 48 (43.6%) were females. Laterality-In 51 (46.3%) left eye was involved, in 20 (18.1%) right eye was involved and in 39 (35.4%) there was bilateral involvement. Mean Age-Mean age of presentation was 3.9 months. SocioEconomic Status-36 (32.7%) children belonged to Poor socioeconomic strata. 40 (36.3%) patients were from Middle socioeconomic strata and 34 (30.9%) patients belonged to Higher socioeconomic strata. Referral Pattern-60 (54.5%) patients were referred by paediatricians after initial treatment, 12 (10.9%) patients were brought by their parents on their own. 38 (34.5%) patients were referred by Registered Medical Practitioners. Success Rate-102 (92.7%) of the children were relieved of their symptoms within 12 weeks of conservative treatment. Only 8 children, i.e. 7.2% who could not get relieved of their symptoms even after the age of 6 months. Out of these 8 patients, symptoms were relieved in 5 patients with single syringing and probing only. Two patients required syringing and probing twice to get their symptoms relieved and only one patient was not cured. CONCLUSION With this study, we conclude that nasolacrimal duct massage has a very high success rate and should be started as early as possible to be more effective. The syringing and probing also have high success rate and should be started as early as six months of age to avoid the morbidity of epiphora and risk of dacryocystitis.